A New Curriculum for Community Medicine

1. A New Curriculum for Community Medicine Don Carufel-Wert Kirsten Rindfleisch Judy Nepokroeff

2. Our goal for all graduates Community responsivephysicians… Family doctors who : •deliver exam-room care which is culturally competent and recognizes the role of community in patients’ health and well-being • facilitate connections between patients and appropriate community-based resources •understand demographic, socioeconomic, and cultural characteristics of their practice community • assess public policy proposals critically, using foundational knowledge of issues in public policy, epidemiology, and occupational health • have the skills needed to develop, implement, and evaluate community-centered outreach projects

3. Limitations of the existing curriculum • Limited content teaching cultural competence • No content teaching health policy, epidemiology, occupational medicine • Heavy emphasis on agency visits • Little structured support for community outreach projects • Limited structured support for individual learning styles and interests • No structured opportunity for dialogue, processing, reflection

4. An overview of the proposal A three week R1 core curriculum combining: ⇛ an orientation to the R1 curriculum ⇛ an orientation to the clinic community ⇛ community resource/agency visits ⇛ community mapping exercise ⇛ web-based learning modules •health policy • cultural competence • occupational health • epidemiology ⇛ structured time for online journaling ⇛ introduction to thepersonalized learning plan

5. An overview of the proposal A complementary longitudinal curriculum: ⇛ Ongoing journaling and dialogue with rotation preceptor ⇛ Ongoing discussion of clinic projects at the afternoon clinic-based teaching conferences ⇛ Protected half-days for project work and work related to the personalized learning plan • 4 half-days in the R1 year • 12 half-days in the R2 year • 4 half-days in the R3 year

6. Strengths of the new curriculum • Expanded set of core topics: including health policy, epidemiology, occupational medicine, and cultural competence • Structured environment for dialogue, processing, and reflection, available online • Principles of adult learning – support for individual learning styles and interests – built into curriculum content and structure • Enhanced accountability and opportunity for competency-based assessment • Longitudinal time for project work – protected, structured, realistic, responsive to clinic needs

7. The Community Medicine website - an integral tool for the new curriculum • Folders and web links containing study materials and course information • Journaling and answering discussion questions • Communication between rotation preceptor and residents • Checklists to track completion of assignments • Room to grow creatively • Access anytime, anywhere

8. The R1 curriculum:1st week1st half day- orientation with rotation preceptor orientation with clinic preceptor further self-guided exploration of web site 3 half days - community mapping exercise3 half days - agency visits 1 half day - processing and writing about week’s experience

9. The R1 curriculum: 2nd week1 half day - cultural competence module1 half day - occupational health module1 half day - health policy module4 half days - agency visits1 half day - processing and writing about week’s experience

10. The R1 curriculum: 3rd week 1 half day - epidemiology module 4 half days - agency visits 1 half day - exploring past and ongoing clinic projects 1 half day - processing and writing about week’s experience 1 half day - rotation evaluation and introduction to the personalized learning plan

11. The R2 and R3 years: An advanced, personalized, and longitudinal experience • Writing and implementing the personalized learning plan • Participation in clinic-based community outreach projects • Discussions at quarterly clinic-based didactic session • Community Medicine home visits • Ongoing journaling and dialogue with rotation preceptor

12. The personalized learning plan ….. an example Learn more about the relationship between health, health care, and the environment • read selections from scientific, policy, and lay literature on pesticides, medical mercury waste, medical plastic waste • meet with leaders of grass-roots organization working to raise local government awareness of environmental justice issues Learn more about possible roles as a physician-activist • meet with Gene and Linda Farley • research existing physician-activist organizations • draft a “pesticide-free DFM” policy, educate colleagues on relevant issues, and advocate for policy’s adoption

13. The Website……

14. Summary New content • learning modules and discussion questions introduce a much broader range of community medicine topics • personalized learning plans emphasize individual goals while maintaining preceptor guidance • formalized proposals for new projects support high- quality work and mimic real-world processes A new tool • journaling, discussion questions, and ongoing preceptor-resident contact prompt reflection and critical thinking, enhancing learning and satisfaction • ongoing preceptor-resident contact and checklists facilitate accountability • D2L platform allows for creative growth

15. Questions?

16. Action items: • Personalized learning plan for R2-R3 years • Longitudinal time allotment for R2-R3 years • Community outreach project restructuring • Job descriptions for rotation and clinic preceptors